Effects of using the clinical respiratory score (CRS) on timeliness of care and staff satisfaction in pediatric patients with respiratory diseases

Abstract

Background: Respiratory diseases are a major cause of hospitalization among pediatric patients, necessitating accurate and timely assessment of disease severity. One tool developed for evaluating the severity of respiratory distress in children is the Clinical Respiratory Score (CRS), which is recognized for its simplicity, the minimal need for complex equipment, and its effectiveness in monitoring changes in clinical status over time. At the Pediatric Ward and Pediatric Intensive Care Unit (PICU) of Songkhla Hospital, delays in pediatric patient assessment have been observed, along with incomplete evaluations and reports. In addition, nurses often face challenges in clearly identifying the severity of respiratory distress. Therefore, this study was conducted to examine the effects of implementing the Clinical Respiratory Score (CRS) on the timeliness of care and the satisfaction of healthcare personnel in pediatric patients with respiratory conditions.

Objective: The primary objective of this study was to evaluate the timeliness of using the Clinical Respiratory Score (CRS) in assessing the severity of respiratory distress. The secondary objective was to assess the satisfaction of healthcare personnel with the use of the CRS tool in the care of pediatric patients with respiratory conditions.

Method: This study employed a one-group quasi-experimental design with post-test–only measurement. The sample consisted of 45 participants selected through purposive sampling. The research instruments included: (1) a general information form for the participants, (2) a record form for measuring the time taken to assess and manage patients within 60 minutes, (3) the Clinical Respiratory Score (CRS) for evaluating the severity of respiratory distress, and (4) a satisfaction questionnaire for physicians and registered nurses. Data were analyzed using a One-Sample t-test (post-test only).

Results: The results showed that the mean time for patient assessment using the CRS and subsequent intervention was 24.2 minutes (SD = 11.37). A one-sample t-test was conducted to compare this observed time with the standard benchmark of 60 minutes. The results indicated a statistically significant difference (t = -21.1, p < 0.001), demonstrating that the observed mean time was significantly shorter than the established standard. Additionally, after the implementation of the CRS for assessing the severity of respiratory distress, physicians and nurses (n = 20) reported a high level of satisfaction (M = 55.5, SD = 5.94), with statistical significance at the 0.001 level.

Conclusion: The use of the Clinical Respiratory Score (CRS) to assess the severity of respiratory distress in pediatric patients with respiratory conditions can enhance the timeliness of patient care and is highly accepted by healthcare personnel (physicians and registered nurses). Therefore, it is an appropriate approach for practical implementation in healthcare settings. In addition, it may help reduce delays in patient management and further improve patient safety.